Q. I would like to get rid of the lines when I smile. Is a facelift the answer?
A. Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.
Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.
Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.
A face and neck lift will pull on the bedspread and stretch the wrinkles and only remove the wrinkles excised with the skin (which is around the ear). Surgical lifts will NOT remove wrinkles.
It is the consistency and texture of your skin, fat and muscle which produces the laxity of the skin and creasing leading to wrinkles.
In counseling my patients, I generally recommend the following order dependent on medical requirements, budget and recovery time:
- ZO Obagi Skin Health
- Face and neck lift; fat grafting, upper / lower eyelids and brow lift as desired
- Continued ZO Skin Health
- Patience to allow the tissues to soften and settle
- Botox to adjust expression lines and Filler to fill in or volumize
- Chemical Peels or laser tightening
- Sculptra firming yearly

